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ROYAL SOCIETY OF EDINBURGH

PERSONAL RESEARCH FELLOWSHIP

Please read the attached regulations carefully before completing this application form. The form must be completed electronically in font size 11.

The information provided in the application form will be treated as strictly confidential

FOR OFFICE USE ONLY
REC / RFC / DSCN / INF

Data Protection Consent

The RSE accepts and processes your personal data which is held on an RSE database. The RSE holds this data in confidence and will not release it to any third party without your consent. Please read the statement below and tick the box provided if you agree to its provisions. Please note that if you do not agree, the RSE may not be able to process your application or award a Research Fellowship to you.

I confirm that by completing this application form I accept and consent to the transfer of my personal data to the Scottish Government and its auditors, agents including any supplier processing such data and to third parties involved with the delivery, audit, review and evaluation of the Fellowship Programme, anywhere in the world, in each case for the purpose of evaluating my application for a Research Fellowship, the conduct by me of any such Research Fellowship, and for auditing, evaluating and reviewing the Research Fellowship Programme as a whole or in part and all related programmes.

Gender(The Royal Society of Edinburgh operates a policy of equality of opportunity and fair treatment).

Male Female Prefer not to say

Subject

Please indicate which area your research is in:

Biomedical Sciences* / Health and Life Sciences / Engineering / PhysicalSciences
Mathematical and Computational Sciences / Environmental Sciences / Social Sciences / Other:
Name of Applicant:
Title of Proposed Research:
Proposed Institution and Department:

2015 Royal Society of Edinburgh Personal Research Fellowship Application Form

The Royal Society of Edinburgh, Scotland’s National Academy, is Charity No. SC000470 Page 1 of 7

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*Applicants in the Biomedical Sciences will be eligible for funding from the Caledonian Research Fund (CRF) and if successful, will be subject to agreement with the host institution to share 50% of costs with the RSE in the final two years of the five-year Fellowship.

2015 Royal Society of Edinburgh Personal Research Fellowship Application Form

The Royal Society of Edinburgh, Scotland’s National Academy, is Charity No. SC000470 Page 1 of 7

1. / PERSONAL DETAILS
Surname : / Forenames :
Correspondence address :
Telephone number : / Fax number :
E-mail : / Mobile number:
Nationality :
Do you require a Visa to work in the UK? / Yes / No
Do you have a Visa to work in the UK? / Yes / No
If you have applied for a Visa, when do you expect to hear the outcome of your application?
If you have not applied, when do you intend to apply?
(Visa information and advice can be obtained from Talent Scotland, see “Application Information” in Regulations for contact details.)
2. / PRESENT APPOINTMENT
Name and address of present employer :
Your Position : / Date of Appointment :
Current Salary : £ / Spine Point: / Salary Source :
Field of work and responsibilities :
3. / PROPOSED RESEARCH
3.1 / Please give a summary of your proposed research written in layman’s terms, indicating its nature, objectives, outputs and how it relates to previous/current work (maximum 150 words). A more detailed account of the project (3 sides of A4) in accordance with the regulations should also be included with the application.
3.2 / Outcomes– please see Item 12 of Regulations
3.3 / Impact – please see Item 13 of Regulations
3.4 / Is your proposed research conditional on receiving any other research grants?
Yes No
If yes, please give details :
3.5 / Are you actively seeking funding from other sources? / Yes / No
If yes, please give details :
If no, please give reasons :
3.6 / Of what benefit to your future career is the proposed programme of research?
FELLOWSHIP DETAILS
Proposed Institution
NB This Fellowship can only be held in a Scottish institution
Please give details of the institution and the department in which you propose to hold the Fellowship. Please indicate if you are moving from your present institution and the reason(s) for choosing the proposed institution.
Expected Salary / £ / Spine Point
Start date
If a Fellowship were granted, are there any reasons why this could not start on 1 October 2015?
5. / ACADEMIC CAREER
5.1 / Please give details of your undergraduate course, all degrees and qualifications gained, with dates, awards and positions held.
5.2 / Career Break
If a career break(s) has been taken, please provide details (including dates) and reasons for the break(s), e.g. maternity leave, national service, voluntary service overseas.
5.3 / Post-doctoral research
Please state the number of years of post-doctoral research experience from the date of final viva to the application closing date of 16 February 2015.
3.
6. / PUBLICATIONS
A list of all your publications should be enclosed with this application form (separately list publications in refereed journals). Please highlight your name in those publications where joint authorship has occurred.
6.1 / Please give details of the number of publications you have had to date and how many papers are in refereed journals.
6.2 / Please list below the three publications from your list which you consider most significant in relation to your proposed research project.
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7. / OTHER EXPERIENCE AND INTERESTS
Please give details of outside activities, membership of professional societies or clubs, sports, hobbies, recreations etc.
8. / MARKETING OF FELLOWSHIP AWARD
Please state where you saw this award advertised or how you heard about it.
9. / REFEREES
Please give the names, addresses, telephone numbers and email addresses of two academic referees.NB. It is your responsibility to ask your referees to send a confidential report, on the form provided, directly to the Research Awards Officer. See Item 18 of the Regulations.
1. / 2.
10. / STATEMENT
(This statement must be signed by an administrative officer eg Finance Officer,and the Head of the Department of the proposed institution. Otherwise, it will not be considered a valid application).
We have read this application and agree that if a Royal Society of Edinburgh Personal Research Fellowship is awarded to the applicant, this institution will provide the necessary facilities and administer the Fellowship.
We understand that applicants in the Biomedical Sciences may be appointed a Fellowship funded by the Caledonian Research Fund which will be subject to agreement to be negotiated to share costs with the RSE in the final two years.
Signature : / Date :
Name :
Position :
Institution :
Address:
Signature : / Date :
Name :
Position :
Institution :
Address:
11. / ACCEPTANCE OF CONDITIONS (to be signed by the applicant)
I have read the particulars of the Royal Society of Edinburgh Personal Research Fellowship and agree to abide by the conditions attached to it.
Signature : / Date :

2015 Royal Society of Edinburgh Personal Research Fellowship Application Form

The Royal Society of Edinburgh, Scotland’s National Academy, is Charity No. SC000470 Page 1 of 7